肾移植术后淋巴细胞亚群的变化与移植肾功能恢复状况分析  

Analysis of the Changes of Lymphocyte Subsets and Functional Rehabilitation of Transplanted Kidney after Renal Transplantation

作　　者：高钰[1] 肖漓[1] 何秀云[1] 黄海燕[1] 樊文梅[1] 魏玉香[1] 马锡慧[1] 孔祥瑞[1] 韩永[1] 许晓光[1] 王新颖[1] 石炳毅[1] 

机构地区：[1]解放军309医院全军器官移植研究所北京市器官移植与免疫调节重点实验室,北京100091

出　　处：《解放军医药杂志》2015年第7期6-9,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家高技术研究发展计划(2012AA021002);首都卫生发展科研专项项目(2014-2-5071)

摘　　要：目的分析肾移植术后淋巴细胞亚群的变化与移植肾功能恢复状况的关系。方法收集2013年9月—2014年3月收治的40例术后2周未发生感染或排斥反应的肾移植受者,术后7 d血肌酐值仍>400μmol/L的病例为延迟恢复组(n=12),其余为功能稳定组(n=28)。分别采术前、术后3、7、14 d静脉血,监测T、B淋巴细胞亚群百分比及绝对计数。结果 T、B淋巴细胞和自然杀伤细胞(NK)百分比及绝对计数在功能稳定组与延迟恢复组中有不完全相同的变化趋势;CD4+/CD8+比值变化也不明显。与功能稳定组相比,延迟恢复组术后3 d外周血CD3+百分比明显下降,NK百分比明显升高(P<0.05);术后7 d CD3+和CD4+百分比及绝对计数均明显下降(P<0.05);术后14 d CD4+和CD4+/CD8+比值明显下降(P<0.05)。结论监测肾移植受者T、B淋巴细胞亚群百分比及绝对计数有助于指导免疫抑制药物的合理应用。Objective To analyze the relationship between the changes of lymphocyte subsets and functional rehabilitation of transplanted kidney after renal transplantation. Methods A total of 40 recipients of renal transplantation without pathogen infection or graft rejection within postoperative 2 weeks,during September 2013 and March 2014 were recruited in the study. According to the value of serum creatinine 7 d after the operation,the recipients were divided into the delayed recovery group（ n = 12,the value 400 μmol / L） and the stable function group（ n = 28）. The venous blood samples were respectively collected before and on 3rd,7thand 14 thd after the transplantation,and then the percentage and absolute counting of T and B lymphocyte subsets in peripheral blood were examined. Results The different changes of the percentages of T and B lymphocytes and natural killer（ NK） cells were found,while the CD4 ＋ / CD8 ＋ ratios did not significantly change on different time points in the stable function group or delayed recovery group. Compared with those in the stable function group,in the delayed recovery group,CD3 ＋ cell percentage on postoperative 3rdd was significantly decreased,and the percentage of NK cells was significantly increased（ P 0. 05）; the values of percentage and absolute count of CD3 ＋ T and CD4 ＋ cells were significantly decreased on postoperative 7thd（ P 0. 05）; the percentage of CD4 ＋ cells and ratio of CD4 ＋ / CD8 ＋ were significantly decreased on postoperative 14thd（ P 0. 05）. Conclusion Monitoring percentage and absolute count of T and B lymphocyte subsets is beneficial to the rational use of immunosuppressive agents.

关 键 词：肾移植 B淋巴细胞亚群 T淋巴细胞亚群 监测 免疫学 

分 类 号：R699.2[医药卫生—泌尿科学]